Job: Case Manager & Drg Assurance Specialist - Job #: 63520BR

Imagine Yourself Here:

A place to be your best! At Aurora Health Care we believe that each of us can use our knowledge, experience and creativity to find better ways of providing patient centered care. We're a non-profit organization with a clear vision. Our strength stems from teamwork and collaboration among a talented and diverse group of professionals. At hospitals, clinics, pharmacies, offices and home care agencies throughout eastern Wisconsin, we're finding better ways.

Better choice. Better career. Better life.

Job Title

Case Manager & Drg Assurance Specialist

Building Code

HM-Aurora Medical Center, Hartford

Address

1032 E Sumner St

City

Hartford

# Hours Per Pay Period (Bi-weekly)

72

Schedule

Required hours: 7:00am-3:30pm, 9:00am-5:30pm

Weekend Hours:

Required hours: 7:00am-3:30pm, 9:00am-5:30pm

Req # (optional)

63520BR

Explore a Career In

Nursing Services

Job Description

Aurora Health Care was created around the idea that there is a better way to provide health care. We are currently seeking a dedicated Case Manager & Drg Assurance Specialist for our Aurora Medical Center, Hartford who is enthusiastic about providing exceptional patient care. Imagine yourself...
*Serving as an educator and resource to the medical staff and hospital staff regarding hospital resource utilization issues, relevant regulatory and documentation requirements.
*Collaborating with physicians daily regarding patient care course. Making suggestions in expediting care and modification to a tentative plan on a timely basis, if necessary.
*Working as a member of the Outcome Facilitation Team (OFT) in a collaborative and proactive manner to promote best practice. Along with the Patient Care Manager and Clinical Nurse Specialist of the unit, proactively works to achieve the objectives outlined in the multidisciplinary Outcome Facilitation Team meetings.
*Promoting effective professional relationships with physicians, other department members and hospital staff; facilitating problem solving, as appropriate.
* Facilitating communications between and negotiates with the patient/family, physicians, nurses, dietary, rehab, homecare, social services, and other disciplines that need to collaborate to provide care for the patient in order to expedite care delivery and appropriate documentation to avoid delays in service provision. Validating care that is provided.

General Qualifications

*Current Registered Nurse (RN) license granted by the State of Wisconsin.
*Knowledge, skills, and abilities required to perform this job are typically acquired through 3-5 years of clinical experience. Experience related to the area/function in which care management or utilization management will be performed preferred.
*Knowledge of DRG payor issues including documentation requirements and reimbursement policies helpful.
*Knowledge of the components of quality and acute patient care needs specifically related to the area/function in which care management will be performed.
*Excellent analytical and Interpersonal communication skills necessary to negotiate with families, patient, physicians and third party payers for optimum plan.
*Working knowledge of Medicare reimbursement and coding structures.
*Knowledge of care delivery documentation systems and related medical record documents.
*Demonstrated ability to work well with physicians and other professionals in a direct and positive manner.
*Demonstrated ability to operate all equipment necessary to perform the job, i.e., FAX, computer, copier, telephone system.


Desired Qualifications

*Previous experience in CM role preferred, but not necessary.
*Positive communication skills that achieve outcomes with diverse physicians.


This position is open due to a military leave:

No

Discover the Benefits:

Imagine a workplace where you are valued for Finding Better Ways and are offered flexibility, mobility and growth through a wide range of career options. With Aurora you'll find a diverse and comprehensive blend of benefits designed to make your life better both inside and outside of the workplace.